Flores Tonatiuh, Kremsner Barbara, Schön Jana, Riedl Julia, Sabitzer Hugo, Glisic Christina, Pfoser Kristina, Nedomansky Jakob, Bergmeister Konstantin D, Schrögendorfer Klaus F
Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria.
Clinical Department of Plastic, Aesthetic and Reconstructive Surgery, University Clinic of St. Poelten, 3100 St. Poelten, Austria.
J Clin Med. 2024 Dec 19;13(24):7779. doi: 10.3390/jcm13247779.
Lipedema is a subcutaneous adipose tissue disorder mainly affecting women. Its progressive nature often requires high-volume liposuction for efficient pain reduction. However, aspiration volumes of more than 5 L within a single session may lead to a variety of complications. Thus, we examined the effect of high-volume liposuctions on lipedema patients and the incidence of associated complications. We analyzed perioperative differences in lipedema patients undergoing low- or high-volume liposuctions. Statistical analyses were performed, investigating postoperative complications and the correlation of patients' BMI, total amount of aspiration, duration of surgery, hospital stay and hemoglobin alterations. Complications were investigated according to the Clavien-Dindo Classification. Patients were divided in two groups based on the volume aspirated at liposuction (low-volume vs. high-volume liposuction). Overall, 121 sessions were investigated. Mean total volume of aspiration was 8227.851 mL ± 3643.891. Mean preoperative hemoglobin levels were 13.646 g/dL ± 1.075 g/dL. Preoperatively, 7.44% of patients were anemic (Hb < 12 g/dL). Mean postoperative hemoglobin was 10.563 g/dL ± 1.230 g/dL. Postoperatively, 90.10% of patients showed Hb levels below 12 g/dL. Hemoglobin loss differed significantly between the two groups ( = 0.001). Significant correlations between pre- ( = 0.015) and postoperative ( < 0.001) hemoglobin levels and pre- ( < 0.001) and postoperative ( < 0.001) anemia with Class II complications were also seen. The total volume of aspiration did not correlate with complication rates ( = 0.176). Complication rates in high-volume liposuctions are hemoglobin-dependent rather than volume-associated. Preoperative anemia was the most influential for the occurrence of postoperative complications. To safely conduct high-volume liposuctions in lipedema patients, adequate patient selection and preoperative patient preparation are imperative.
脂肪性水肿是一种主要影响女性的皮下脂肪组织疾病。其渐进性往往需要进行大容量抽脂以有效减轻疼痛。然而，单次手术抽吸量超过5升可能会导致多种并发症。因此，我们研究了大容量抽脂对脂肪性水肿患者的影响以及相关并发症的发生率。我们分析了接受小容量或大容量抽脂的脂肪性水肿患者的围手术期差异。进行了统计分析，调查术后并发症以及患者的体重指数、抽吸总量、手术时间、住院时间和血红蛋白变化之间的相关性。根据Clavien-Dindo分类法对并发症进行了调查。根据抽脂时的抽吸量将患者分为两组（小容量抽脂组与大容量抽脂组）。总体而言，共调查了121例手术。平均抽吸总量为8227.851毫升±3643.891毫升。术前平均血红蛋白水平为13.646克/分升±1.075克/分升。术前，7.44%的患者贫血（血红蛋白<12克/分升）。术后平均血红蛋白为10.563克/分升±1.230克/分升。术后，90.10%的患者血红蛋白水平低于12克/分升。两组之间的血红蛋白损失差异显著（P = 0.001）。术前（P = 0.015）和术后（P<0.0）血红蛋白水平以及术前（P<0.0）和术后（P<0.0）贫血与II级并发症之间也存在显著相关性。抽吸总量与并发症发生率无关（P = 0.176）。大容量抽脂的并发症发生率取决于血红蛋白而非抽吸量。术前贫血对术后并发症的发生影响最大。为了在脂肪性水肿患者中安全地进行大容量抽脂，必须进行充分的患者选择和术前患者准备。
